gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Quality of life assessment for patients with osteonecrosis of the femoral head – multicenter study

Meeting Abstract

  • presenting/speaker Takashi Sakai - Dept of Orthopaedic Surgery, Osaka Univ, Suita, Japan
  • Yuko Uesugi - Dept of International Health, Kobe Univ, Kobe, Japan
  • Taisuke Seki - Dept of Orthopaedic Surgery, Nagoya Univ, Nagoya, Japan
  • Shinya Hayashi - Dept of Orthopaedic Surgery, Kobe Univ, Kobe, Japan
  • Nobuhiko Sugano - Dept of Orthopaedic Medical Engineering, Osaka Univ, Suita, Japan

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN14-869

doi: 10.3205/17dkou032, urn:nbn:de:0183-17dkou0322

Published: October 23, 2017

© 2017 Sakai et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Quality of life (QOL) assessment in patients with osteonecrosis of the femoral head (ONFH) has been sporadically reported and it is still unknown. This study aimed to elucidate the relationship between disease severity and QOL, and between patients' characteristics and QOL in ONFH.

Methods: This multicenter study was performed in 17 institutions (XXX) and included 235 ONFH patients. There were 92 females and 143 males with a mean age of 47.4±14.7 years. All patients were investigated concerning patients' characteristics including disease related factors in ONFH (steroid use and alcohol intake). They are also radiologically examined using plain radiographs and magnetic resonance imaging. Disease severity was evaluated based on JIC radiological staging system (1, 2, 3A, 3B, 4), type classification system (A, B, C1, and C2), and multiple osteonecrosis (MP). Self-assessment QOL questionnaire sheets which included the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), Oxford Hip Score (OHS), and SF-12v2 were filled out by the patients. JHEQ consisted of pain, movement, and mental condition, and each maximum subscale was 0-28 points. Satisfaction level was also assessed as JHEQ(satisfaction) and higher score showed unsatisfactory level. We investigated the relationship between disease severity and QOL score, and between patients' characteristics and QOL score.

Results and Conclusion: JHEQ(pain/movement) was 24.8±6.5/11.6±4.2 for typeA, 21.5±7.9/13.0±6.3 for typeB, 15.7±9.0/10.8±7.1 for typeC1, and 11.2±7.8/7.2±6.6 for typeC2, respectively. JHEQ (pain/movement) was 22.0±8.6/13.1±7.7 for stage1, 20.0±8.3/11.7±6.1 for stage2, 11.4±7.3/8.7±6.9 for stage3A, 9.4±7.0/6.0±6.0 for stage3B, and 11.1±7.0/6.3±5.7 for stage4, respectively. JHEQ(satisfaction) was 85.5±19.1 in younger patients (< 40 years) and 76.8±25.1 in older patients (>40 years) (p<0.01). JHEQ(movement) was 9.2±7.1 in younger patients and 6.6±6.8 in older patients (p=0.013). SF-12(mental) was 54.9±11.7 in younger patients and 50.5±8.7 in older patients (p<0.01). SF-12(physical) was 18.0±12.9 in MP patients and 30.3±14.0 in no MP patients (p<0.05). The factors that associated with JHEQ(satisfaction) differed according to differences in the disease related factors. Namely, steroid use has moderately related with JHEQ(pain)(r=-0.57), JHEQ(movement)(r=-0.45), JHEQ(mental)(r=-0.49), OHS(r=-0.58), and SF-12(physical)(r=-0.46), while alcohol intake has moderately related with JHEQ(mental)(r=-0.51) and SF-12(social functioning) (r=-0.49).

Patients with large necrotic lesion type (C1, C2) and collapsed stage (3A, 3B, and 4) showed low QOL score. Younger patients showed more unsatisfactory for ONFH. Older patients indicated worse score in physical function and in mental condition. MP patients showed less physical function score. The factors associated with satisfaction level were different among steroid-related and alcohol-related patients.